We’ve all heard the name Freud. Often the name is thrown around as a synonym for silly preoccupations with mother-lust, castration fear or penis envy. The bizarre and eyebrow-raising features of an isolated working model for understanding human suffering that ought to be relegated to the historical dust bin, right?
And why ever take seriously this quirky, historical system of ideas when we have a simple, structured, step-by-step, evidence-based approach endorsed by basically all major insurance companies, i.e., CBT (cognitive behavioral therapy)? It is so seductive (for both therapists and clients) to imagine that happiness, wellness, and “getting better” will be a streamlined, structured, quick set of explorations of one’s glitches in thinking.
A rigorous study of psychoanalysis, weighed against “treatment as usual” (usually involving CBT) was published by London’s Tavistock Clinic in 2015 showed that 18 months of psychoanalysis were actually far more effective and had far more long-lasting results, than “treatment as usual”. This study was preceded by a series of studies and meta-analyses going back to the 1990s yielding similar conclusions.
Let me quickly make it clear that psychoanalysis, and psychoanalytic psychotherapy, is not all about analyzing the client’s or patient’s lust for a parent, their castration fear, or their penis envy. Far from it. I have attended numerous trainings at the Jung Institute in San Francisco, and I have attended an intensive training with one of the greatest living analysts, Dr. Clarissa Pinkola Estes, and I employ psychoanalytic techniques and theoretical orientations in my work regularly. I have never mentioned, or even been concerned, with any of the typical, ludicrous-seeming emblems of Freudian psychoanalysis. What seems to differentiate this kind of approach from a more CBT-style approach is a fundamental disagreement about the nature of human suffering, and how to ease it.
According to a more CBT-style approach, the symptoms or problems with which someone comes into the therapy office are seen as problematic growths to be excised as rapidly as possible. According to a more psychoanalytic approach, the symptoms or problems with which someone comes into the therapy office carry a deeper meaning which is unique to the individual, and deserve to be understood in the context of the individual’s depths and complexity, the full dimensions of which are rarely (if ever) fully appreciated or grasped, even by the individual herself. A psychoanalytic approach requires for the therapist to constantly apply her mind, in each moment, to the unique multitudes of the individual before her, and to remain curious about the underlying cause(s) of the distress.
I’ve always been fascinated by people’s stories, and by the uniqueness and depth of each human experience, and by the complexity of human emotional life. So naturally, a more psychoanalytic approach appeals to me a great deal. And it really appeals to many others a great deal. But it doesn’t appeal to all. And that’s okay!
What it comes down to is the individual’s underlying assumptions about the nature of human suffering, and of their own suffering, and thereby, what kind of approach most agrees with them. Of course, there is no one therapeutic approach that is the silver-bullet for all psychological maladies. And CBT does have its merits. I often weave some CBT techniques into my approach with clients who are not interested in going “deeper” (through EMDR, or through the use of a more psychoanalytic approach), or with clients with whom I do discern some glaring cognitive errors, and for whom some basic Socratic questioning might ease suffering significantly in the short-term. It’s part of the basic triaging of concerns that I am constantly doing with clients as I tailor therapy to them and what they are bringing in week-by-week in the beginning, middle and end of the arc of therapy.
If you are curious about whether a more psychoanalytic approach is appropriate for you, ask yourself, Am I willing to view my symptoms or problems as doorways into a deeper, and more compassionate understanding of myself and my astonishing depths, and thereby, transmute and integrate them? Or would I prefer an approach that helps me to eradicate my symptoms or problems as efficiently as possible? There is no right or wrong answer to this. And yet it would certainly be helpful to ponder this in your selection of a therapist, and in your ongoing search for a therapist, with the the overwhelming array of choices.
If you’re interested in a more depth-oriented, or psychoanalytic, approach, click the link here to schedule a consultation and see if we’d be well-matched!